Objective:To determine the incidence of acute focal bacterial nephritis (AFBN) in children with febrile urinary tract infections (UTI) and to identify associated risk factors.Methods:A retrospective cohort study included 181 children hospitalized with febrile UTI at Fujian Children′s Hospital from April 2021 to September 2023. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into AFBN group and non-AFBN group based on AFBN diagnosis. The incidence of AFBN within this febrile UTI cohort was determined. The diagnostic value for pre-antibiotic blood white blood cell (WBC) count and C-reactive protein (CRP) level, along with post-treatment fever duration and pyuria duration for AFBN was evaluated using the area under curve (AUC) of the receiver operating characteristic (ROC).Results:The cohort comprised 181 children with febrile UTI (100 boys and 81 girls), age of 0.6 (0.3, 1.0) years. Eleven patients (6.1%) were diagnosed with AFBN. For predicting AFBN, the AUC was 0.71 (95% CI 0.55-0.85, P=0.026) for pre-antibiotic WBC count and 0.80 (95% CI 0.71-0.90, P=0.001) for pre-antibiotic CRP level, with optimal cutoff values of 16.0×10 9/L and 80.1 mg/L, respectively. For post-treatment parameters, the AUC was 0.79 (95% CI 0.69-0.92, P=0.001) for fever duration and 0.84 (95% CI 0.72-0.97, P<0.001) for pyuria duration, with optimal cutoff values of 1.9 d and 5.5 d, respectively. The combination of pre-antibiotic WBC count >16.0×10 9/L and CRP>80.1 mg/L yielded a sensitivity of 0.73 and a specificity of 0.86 for AFBN prediction. Similarly, the combination of post-treatment fever duration ≥2 d and pyuria duration >5 d demonstrated a sensitivity of 0.82 and specificity of 0.88. Conclusions:AFBN incidence was 6.1% in this cohort of children with febrile UTI. AFBN should be highly suspected in febrile UTI children presenting with either a pre-antibiotic WBC count >16.0×10 9/L and CRP >80.1 mg/L, or a post-treatment fever duration ≥2 d and pyuria duration >5 d.

Objective To evaluate the clinical efficacy of Zhuanggu Kangsong Soft Extract combined with percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods A total of 90 eligible OVCF patients admitted to Guangzhou Integrated Chinese and Western Medicine Hospital between January 2023 and May 2024 were enrolled and randomly divided into an observation group(n=45)and a control group(n=45)using a random number table.Both groups underwent PVP.After treatment,the control group received conventional western medication orally(calcium carbonate D3 tablets+calcitriol soft capsules),while the observation group received additional Zhuanggu Kangsong Soft Extract treatment orally.Western medication was administered for 6 months,and herbal treatment lasted 3 months.Changes in Visual Analogue Scale(VAS)scores for pain,Oswestry Disability Index(ODI)scores for low back function,bone mineral density(BMD)T-values,and serum bone metabolism markers were observed before and after treatment.Results(1)At postoperative day 3,3 months,and 6 months,both groups showed significant improvements in VAS and ODI scores compared to those before treatment(P＜0.05).The observation group demonstrated superior improvements in VAS and ODI scores at 3 and 6 months compared to the control group(P＜0.05).(2)At 3,6,and 12 months postoperatively,BMD T-values were improved in both groups(P＜0.05),with the observation group exhibiting greater improvements at 6 and 12 months(P＜0.05).(3)Serum N-terminal osteocalcin and 25-hydroxyvitamin D3[25(OH)D3]levels increased in both groups at 1,3,and 6 months(P＜0.05).The observation group showed more pronounced elevations in these markers at 3 and 6 months(P＜0.05).Conclusion The combination of Zhuanggu Kangsong Soft Extract and PVP demonstrates significant therapeutic benefits for OVCF by effectively alleviating pain,enhancing BMD,and improving activities of daily living,which highlights its high clinical value.

Objective To investigate the factors influencing the persistence of residual low back pain following percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral fractures(OVF),in order to provide a scientific basis for clinical intervention strategies.Methods A retrospective analysis was conducted on data from 1 120 patients diagnosed with OVF who received PVP treatment between July 2020 and June 2025.Among them,61 patients who experienced residual low back pain in the early postoperative period(defined as 2 days to 1 month after surgery)with a postoperative visual analog scale(VAS)score greater than 3 points were selected as the observation group.An additional 61 control subjects were matched to the observation group at a 1∶1 ratio based on age(±5 years),gender,and preoperative bone mineral density(±0.5 standard deviation).Univariate and logistic regression analyses were subsequently performed to evaluate potential influencing factors.Results Univariate analysis revealed statistically significant differences between the two groups with respect to preoperative thoracolumbar fascia injury(TFI),MRI-detected liquefaction signals in the affected vertebrae,the number of involved vertebrae(≥2),and suboptimal bone cement distribution(P<0.05).Multivariate regression analysis confirmed that these factors were independent risk factors,with corresponding odds ratios(ORs)of 5.378,6.111,3.245,and 2.890(all P<0.05).The area under the curve(AUC)of the predictive model was 0.929,indicating a high level of predictive accuracy.Conclusion Preoperative TFI,MRI-demonstrated liquefaction signals in the affected vertebrae,the presence of multiple responsible vertebrae,and suboptimal bone cement distribution may contribute to an increased risk of early residual low back pain following PVP.

Objective To investigate the factors influencing the persistence of residual low back pain following percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral fractures(OVF),in order to provide a scientific basis for clinical intervention strategies.Methods A retrospective analysis was conducted on data from 1 120 patients diagnosed with OVF who received PVP treatment between July 2020 and June 2025.Among them,61 patients who experienced residual low back pain in the early postoperative period(defined as 2 days to 1 month after surgery)with a postoperative visual analog scale(VAS)score greater than 3 points were selected as the observation group.An additional 61 control subjects were matched to the observation group at a 1∶1 ratio based on age(±5 years),gender,and preoperative bone mineral density(±0.5 standard deviation).Univariate and logistic regression analyses were subsequently performed to evaluate potential influencing factors.Results Univariate analysis revealed statistically significant differences between the two groups with respect to preoperative thoracolumbar fascia injury(TFI),MRI-detected liquefaction signals in the affected vertebrae,the number of involved vertebrae(≥2),and suboptimal bone cement distribution(P<0.05).Multivariate regression analysis confirmed that these factors were independent risk factors,with corresponding odds ratios(ORs)of 5.378,6.111,3.245,and 2.890(all P<0.05).The area under the curve(AUC)of the predictive model was 0.929,indicating a high level of predictive accuracy.Conclusion Preoperative TFI,MRI-demonstrated liquefaction signals in the affected vertebrae,the presence of multiple responsible vertebrae,and suboptimal bone cement distribution may contribute to an increased risk of early residual low back pain following PVP.

Objective:To determine the incidence of acute focal bacterial nephritis (AFBN) in children with febrile urinary tract infections (UTI) and to identify associated risk factors.Methods:A retrospective cohort study included 181 children hospitalized with febrile UTI at Fujian Children′s Hospital from April 2021 to September 2023. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into AFBN group and non-AFBN group based on AFBN diagnosis. The incidence of AFBN within this febrile UTI cohort was determined. The diagnostic value for pre-antibiotic blood white blood cell (WBC) count and C-reactive protein (CRP) level, along with post-treatment fever duration and pyuria duration for AFBN was evaluated using the area under curve (AUC) of the receiver operating characteristic (ROC).Results:The cohort comprised 181 children with febrile UTI (100 boys and 81 girls), age of 0.6 (0.3, 1.0) years. Eleven patients (6.1%) were diagnosed with AFBN. For predicting AFBN, the AUC was 0.71 (95% CI 0.55-0.85, P=0.026) for pre-antibiotic WBC count and 0.80 (95% CI 0.71-0.90, P=0.001) for pre-antibiotic CRP level, with optimal cutoff values of 16.0×10 9/L and 80.1 mg/L, respectively. For post-treatment parameters, the AUC was 0.79 (95% CI 0.69-0.92, P=0.001) for fever duration and 0.84 (95% CI 0.72-0.97, P<0.001) for pyuria duration, with optimal cutoff values of 1.9 d and 5.5 d, respectively. The combination of pre-antibiotic WBC count >16.0×10 9/L and CRP>80.1 mg/L yielded a sensitivity of 0.73 and a specificity of 0.86 for AFBN prediction. Similarly, the combination of post-treatment fever duration ≥2 d and pyuria duration >5 d demonstrated a sensitivity of 0.82 and specificity of 0.88. Conclusions:AFBN incidence was 6.1% in this cohort of children with febrile UTI. AFBN should be highly suspected in febrile UTI children presenting with either a pre-antibiotic WBC count >16.0×10 9/L and CRP >80.1 mg/L, or a post-treatment fever duration ≥2 d and pyuria duration >5 d.

SIRT6,a member of the sirtuin family of histone deacetylases,belongs to the class Ⅲ longevity proteins and exhibits NAD+-dependent deacetylase and mono-ADP-ribosyltransferase activities.SIRT6 is primarily located in the cell nucleus and plays a pivotal role in regulating genomic stability and relative gene expression,participating in the control of key processes such as energy metabolism and aging.Given its crucial role in maintaining cellular homeostasis and organismal health,SIRT6 has emerged as a potential therapeutic target,sparking significant research interest in the development of targeted modulators.Activating the longevity protein with drugs may provide therapeutic strategies for age-associated diseases,including aging,metabolic syndrome,inflammation,and reproductive health issues.The review elaborates the structural characteristics,enzymatic activities,and biological functions of SIRT6,as well as the mechanisms of action,pharmacological activities,and clinical applications of various SIRT6 activators.

Objective:To observe the recurrence condition of hepatitis B in different risk groups after liver transplantation in an attempt to provide useful information on whether to discontinue hepatitis B immunoglobulin (HBIG) in the future at an early stage.Methods:The patient population was divided into high, low-risk, and special groups [especially primary hepatocellular carcinoma (HCC)] according to the guidelines for the prevention and treatment of hepatitis B recurrence after liver transplantation. The recurrence condition and risk factors in this population were observed for hepatitis B. Measurement data were analyzed using a t-test and a rank-sum test. Count data were compared using a χ2 test between groups. Results:This study finally included 532 hepatitis B-related liver transplant cases. A total of 35 cases had HBV recurrence after liver transplantation, including 34 cases that were HBsAg positive, one case that was HBsAg negative, and 10 cases that were hepatitis B virus (HBV) DNA positive. The overall HBV recurrence rate was 6.6%. The recurrence rate of HBV was 9.2% and 4.8% in the high- and low-risk HBV DNA positive and negative groups before surgery ( P = 0.057). Among the 293 cases diagnosed with HCC before liver transplantation, 30 had hepatitis B recurrence after surgery, with a recurrence rate of 10.2%. The independent related factors for the recurrence of hepatitis B in patients with HCC after liver transplantation were HCC recurrence ( HR =181.92, 95% CI 15.99~2 069.96, P < 0.001), a high postoperative dose of mycophenolate mofetil dispersible tablets (MMF) ( HR =5.190, 95% CI 1.289~20.889, P = 0.020), and a high dosage of HBIG ( HR = 1.012, 95% CI 1.001~1.023, P = 0.035). Among the 239 cases who were non-HCC before liver transplantation, five cases (recurrence rate of 2.1%) arouse postoperative hepatitis B recurrence. Lamivudine was used in all cases, combined with on-demand HBIG prophylaxis after surgery. There was no hepatitis B recurrence in non-HCC patients who treated with entecavir combined with HBIG after surgery. Conclusion:High-barrier-to-resistance nucleotide analogues combined with long-term HBIG have a good effect on preventing the recurrence of hepatitis B after liver transplantation. The discontinuation of HBIG may be considered at an early stage after administration of a high-barrier-to-resistance nucleotide analogue in low-risk patients. Domestically, the HBV infection rate is high, so further research is still required to explore the timing of HBIG discontinuation for high-risk patients, especially those with HCC.

ObjectiveTo investigate the effect of Zuoguiwan on pancreatic islet function in offspring of gestational diabetes mellitus （GDM） maternal rat model and explore the mechanisms of Zuoguiwan in improving pancreatic islet function based on postpartum pancreatic regeneration. MethodHealthy female SD rats with normal blood glucose levels were paired with male rats in a 2∶1 ratio and housed together. Pregnancy was confirmed based on vaginal plugs or vaginal smears. The pregnant rats were divided into the following groups： normal group， model group， insulin group （insulin Detemir， 20 U·kg^-1）， low-dose Zuoguiwan group （1.89 g·kg^-1）， and high-dose Zuoguiwan group （3.78 g·kg^-1）. The GDM rat model was induced using streptozotocin in rats except for those in the normal group. The model was confirmed by blood glucose testing in the maternal rats. Except for the normal and model groups， the other groups received daily administration of corresponding treatments. At 21 days after birth， fasting blood glucose （FBG） and fasting serum insulin （FINS） levels were measured in 6 offspring from each group. The homeostasis model assessment of insulin resistance （HOMA-IR） was calculated， and an oral glucose tolerance test （OGTT） was performed on additional 12 offspring from each group. Blood samples were taken from the abdominal aorta of the offspring at postnatal day 22， and enzyme-linked immunosorbent assay （ELISA） was used to measure insulin， glucagon （GC）， pancreatic polypeptide （PPY）， and somatostatin （SS） levels in the serum. Hematoxylin-eosin （HE） staining was performed to observe pathological changes in the pancreatic tissue of the offspring. Immunofluorescence （IF） was used to observe the area and structure of the pancreatic islets. Western blot was used to detect the expression of key proteins involved in the development and functional expression of pancreatic β-cells， namely pancreatic and duodenal homeobox factor 1 （Pdx1）， Nkx6.1， and Glucose transporter 2 （Glut2）. ResultCompared with the normal group， the model group showed significant increases in FBG and FINS levels， and HOMA-IR （P<0.01）. Compared with the model group， the insulin group showed significant decreases in FBG levels and HOMA-IR （P<0.01）， the low-dose Zuoguiwan group showed a significant decrease in FBG levels （P<0.05）， and the high-dose Zuoguiwan group showed significant decreases in FBG and FINS levels， and HOMA-IR （P<0.01）. Compared with the normal group， the model group showed significant increases in OGTT 60-min blood glucose levels and AUC index （P<0.05， P<0.01）. Compared with the model group， the high-dose Zuoguiwan group showed significant decreases in OGTT60-min blood glucose levels and area under the curve（AUC） index （P<0.05， P<0.01）. HE staining of pancreatic tissue showed that compared with the normal group， the model group had a reduced number of islets and a loose arrangement of acinar cells. Compared with the model group， the groups with drug treatment showed increased number of islets and a compact arrangement of acinar cells. Compared with the normal group， the model group had significantly increased levels of insulin， GC， PPY， and SS in the serum （P<0.01）. Compared with the model group， the low-dose and high-dose Zuoguiwan groups and the insulin group showed significantly decreased serum levels of insulin， GC， PPY， and SS （P<0.05， P<0.01）. IF results showed that compared with the normal group， the model group had a significantly lower positive rate of insulin （P<0.05）. Compared with the model group， the low-dose and high-dose Zuoguiwan groups showed a significant increase in the positive rate of insulin （P<0.05）. There was no significant difference in the positive rate of GC among the groups. In terms of the proportion of insulin and GC in individual islets， compared with the normal group， the model group showed a significant decrease in the proportion of insulin （P<0.01） and a significant increase in the proportion of GC （P<0.01）. Compared with the model group， the low-dose and high-dose Zuoguiwan groups showed significantly increased proportion of insulin （P<0.01） and significantly decreased proportion of GC （P<0.01）. Compared with the normal group， the model group showed significantly decreased expression levels of Pdx1， Nkx6.1， and Glut2 proteins in the pancreatic tissue of GDM offspring （P<0.05）. Compared with the model group， the insulin group and the low-dose Zuoguiwan group showed significant increases in the expression levels of Pdx1 and Nkx6.1 proteins in the pancreatic tissue of GDM offspring （P<0.05）， and the low-dose and high-dose Zuoguiwan groups showed significant increases in the expression levels of Glut2 protein （P<0.05）. ConclusionZuoguiwan can promote pancreatic islet development in offspring of GDM maternal rat model， improve pancreatic islet morphology and function， and alleviate insulin resistance. Its mechanism of action may be related to the regulation of Pdx1， Nkx6.1， and Glut2 protein expression in the pancreatic tissue of offspring.

Objective To establish and evaluate chemotherapeutic phlebitis model rats induced by vinorelbine via the dorsalis pedis vein.Methods Rats were divided randomly into control and 4 different concentration of vinorelbine-induced model groups.Control rats were injected with 0.1 mL normal saline via the dorsalis pedis vein of the hind limb,while other rats were injected with different concentrations of vinorelbine(2,3,4,5 mg/mL),as above.General observations were performed and the hind limb volume was measured daily for 7 consecutive days to calculate the swelling rate.The rats were then killed and histological changes in the dorsalis pedis vein were observed by hematoxylin and eosin staining.Microstructural changes on the surface of the vascular endometrium were observed by scanning electron microscopy.Results Injection of 2,3,4,5 mg/mL vinorelbine via the dorsalis pedis vein significantly induced hind limb swelling in a concentration-dependent manner,peaking on day 3 in each group.The phlebitis rates on day 7 were 50%in the 2 mg/mL group and 83.3%in the 3 mg/mL group.Phlebitis was also induced in the 4 mg/mL and 5 mg/mL groups,including grade Ⅲ in 66.6%and grade Ⅳ in 83.3%.Histopathology showed inflammatory cell infiltration,wall thickening,lumen stenosis,and thrombosis in the tissues surrounding the veins.Scanning electron microscopy showed destruction of tight junctions of venous endothelial cells,and a rough surface of the vascular lining,resultsing in blood cell adhesion.Conclusions Injection of 0.1 mL of 3～5 mg/mL vinorelbine via the dorsalis pedis vein could induce red,swollen,and cord-like veins,as well as infiltration of inflammatory cells around the vein,thickened vein walls,lumen stenosis,and thrombosis.In addition,the surface of the venous intima was rough and adhered to numerous blood cells.All these features are consistent with those of clinical chemotherapeutic phlebitis in terms of the symptoms and pathological structure.

Objective:To explore the independent predictive factors of cirrhosis in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection, and establish a nomogram model based on clinical laboratory data and analyze the predictive value of this model.Methods:The laboratory data of 596 patients with HBeAg-negative chronic HBV infection and 677 patients with hepatitis B cirrhosis, who were hospitalized in the First Hospital of China Medical University from 2011 to 2021, were retrospectively analyzed. Patients were randomly divided into training group ( n=892) and validation group ( n=381) at the ratio of 7∶3. The independent predictive factors of cirrhosis were analyzed by univariate logistic regression, multiple collinearity test and multivariate logistic regression. The nomogram model was established and the prediction value of this model was evaluated. Results:According to multivariate logistic regression analysis, hepatitis B core antibody ( OR=1.492, 95% CI 1.316-1.706), glutamine transpeptidase ( OR=1.015, 95% CI 1.010-1.022), platelet ( OR=0.986, 95% CI 0.982-0.988) and albumin ( OR=0.853, 95% CI 0.824-0.882) were independent predictors of cirrhosis ( P<0.05), and the nomogram was established based on the four indicators. Receiver operating characteristic curves showed that area under the curve of the nomogram was 0.933 (95% CI 0.916-0.950), and that of the validation group was 0.931 (95% CI 0.905-0.956). The calibration curves indicated the nomogram model was highly consistent with the actual outcome. Decision curves and clinical impact curves confirmed that the model had high net benefit and good clinical application performance. Conclusions:Hepatitis B core antibody, glutamine transpeptidase, platelet and albumin are independent predictors of cirrhosis among patients with HBeAg-negative chronic HBV infection. The newly developed nomogram model based on these factors could be used to predict cirrhosis risk in these patients.